Efficacy of an expanded ventilator bundle for the reduction of ventilator-associated pneumonia in the medical intensive care unit.
The ventilator bundle (VB) includes a group of clinical maneuvers (head-of-bed elevation, "sedation vacation," deep vein thrombosis prophylaxis, and peptic ulcer disease prophylaxis) to improve outcomes in patients undergoing mechanical ventilation. We modified the standard VB in our medical intensive care unit to include a group of respiratory therapist-driven protocols and, postimplementation, observed a statistically significant (P = .0006) reduction in ventilator-associated pneumonia (VAP), from a median of 14.1 cases/10(3) ventilator-days (interquartile range [IQR] = 12.1 to 20.6) to 0 cases/10(3) ventilator-days (IQR = 0 to 1.1).
Blamoun
John
J
Division of Pulmonary Medicine, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ 07079, USA.
Alfakir
Maria
M
Rella
Marie E
ME
Wojcik
Janice M
JM
Solis
Roberto A
RA
Anees Khan
M
M
DeBari
Vincent A
VA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000517:prevention & control*; D012122:Ventilators, Mechanical / Q000009:adverse effects*; D055815:Young Adult